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Time trends in the etiology of prosthetic joint infections: A multicenter cohort study

Abstract: It is important to know the spectrum of the microbial aetiology of prosthetic joint infections (PJIs) to guide empiric treatment and establish antimicrobial prophylaxis in joint replacements. There are no available data based on large contemporary patient cohorts. We sought to characterize the causative pathogens of PJIs and to evaluate trends in the microbial aetiology. We hypothesized that the frequency of antimicrobial-resistant organisms in PJIs has increased in the recent years. We performed a cohort study in 19 hospitals in Spain, from 2003 to 2012. For each 2-year period (2003-2004 to 2011-2012), the incidence of microorganisms causing PJIs and multidrug-resistant bacteria was assessed. Temporal trends over the study period were evaluated. We included 2524 consecutive adult patients with a diagnosis of PJI. A microbiological diagnosis was obtained for 2288 cases (90.6%). Staphylococci were the most common cause of infection (1492, 65.2%). However, a statistically significant rising linear trend was observed for the proportion of infections caused by Gram-negative bacilli, mainly due to the increase in the last 2-year period (25% in 2003-2004, 33.3% in 2011-2012; p 0.024 for trend). No particular species contributed disproportionally to this overall increase. The percentage of multidrug-resistant bacteria PJIs increased from 9.3% in 2003-2004 to 15.8% in 2011-2012 (p 0.008), mainly because of the significant rise in multidrug-resistant Gram-negative bacilli (from 5.3% in 2003-2004 to 8.2% in 2011-2012; p 0.032). The observed trends have important implications for the management of PJIs and prophylaxis in joint replacements.

 Fuente: Clin Microbiol Infect. 2016 Aug;22(8):732.e1-8

Editorial: Elsevier

 Año de publicación: 2016

Nº de páginas: 30

Tipo de publicación: Artículo de Revista

 DOI: 10.1016/j.cmi.2016.05.004

ISSN: 1198-743X,1469-0691

Autores/as

BENITO, NATIVIDAD

FRANCO, MARÍA

RIBERA, ALBA

SORIANO, ALEX

RODRIGUEZ PARDO, DOLORS

SORLÍ, LUISA

FRESCO, GEMA

TORO, MARÍA DOLORES DEL

GUÍO, LAURA

SÁNCHEZ RIVAS, ELENA

BAHAMANDE, ALBERTO

RIERA, MELCHOR

ESTEBAN, JAIME

BARAIA ETXABURU, JOSU MIRENA

MICHEL FAKKAS FERNANDEZ

CARLOS GARCES ZARZALEJO

MARIA CONCEPCION FARIÑAS ALVAREZ

LUIS MARTINEZ MARTINEZ

SALAS VENERO, CARLOS